1997, 09-24 Permit: 97008192 RefundREFUND
Pv# MVC923700C9
Dept iC FAJTl D r.
VENDOR:
FALCO STOVE
SHOP
9310 E SPRAGUE AVE
SPOKANE
Vendor ContactlTel
PLAN
WA 99206
LGFS PAYMENT DOCUMENT
SPOKANE COUNTY AUDITOR
SHIP TO:
Confirming Order
BILL TO:
PV MV092370009
Change Order #
Bid ID
Blanket#
RC#
VI#
FOB:
ACCTG. PERIOD: 09/97
COMMENTS:
PO DATE: BLDG/ROOM:
DELIVERY DATE: WAREHOUSE:
ENTEREDBY: PATRICIA EICKSTADT
BUYER
PURCHASINGDIRECTOR:DONALD L. LABRECQUE
COMM LN#
DESCRIPTION
•1
COMMODITY NO-.
-`4I*REF ACCT LINE 1'^ •
QUANTITYtf.
#'UNIT PRICE 4""-
-TOTAL PRICE
80%, CANCELLED, PRJ497-7360
SITE: 13227 E. GUTHRIE DR.
SPOKANE WA 99216
DIST: "F"
PAGE TOTAL:
DISCOUNT TOTAL:
FREIGHT TOTAL:
SALES TAX TOTAL:
PURCHASE ORDER VALUE:
USE TAX TOTAL:
GRAND TOTAL:
37.60
37.60 .
0.00
0.00
0.00
37.60
0.00
37.60
LINE NO.
FUND
AGCY
ORG
SB ORG
ACT -
OBT
SB OBI
REV SR
CSB REV
RPT CAT
BS ACCT
TOB NO.
PAY THIS.AMOUNT
P/F
01
406
030 0008
2210
07
TOTAL TO VENDOR:
37.60
37.60
RECEIVING 1 ERTIFICATION
Matals noe gir quantity have been
recei. -d in g conditio co vaned
SIGNED-ako retli i
TITLE A CT TECH 3 SIGNED
DATE 90497
certify under penalty r perjury that sufficient funds hate been budgeted for this claim, the
services rendered or labor performed as described herein or contracted for, that the claim Is
against Spoka, County or fund agency indicated above, that 1 am authorised to authenticate
DATE • 9/24/97
TITLE OFFICE ADMINISTRATOR
ACCOUNTS PAYABLE
TRAVEL CERTIFICATION
1 hereby certify under penalty of perjury that this
Is a true and correct daim for necessary expenses
incurred by me and that no payment has been received
by me on account thereof.
SIGNED TITLE
DATE
PAGE
1
SPOKANE COUNTY DIVISION OF BUILDING AND PLANNING
1026 W. BROADWAY • SPoKANE, WA 99260-0050
(509) 456-3675
SITE ADDRESS: 13227 E GUTHRIE DR
SPOKANE WA 99216
PARCEL NUMBER: 45274.1532
SUBDIVISION: HILLCREST ACRES 2ND ADD
LOT: BLOCK: ZONE: UR -3.5
PROJECT NUMBER: 97007360 ISSUE DATE: •;-L 8/97
PERMIT USE: (2) GAS LOCUS), 8 PIPING (2
INSPECTOR: FRANK PALADICNUK
WATER DIST:
APPLICANT: FALCO STOVE SHOP
PHONE: 509 926 8911
ADDRESS: 9310 E.SPRAGUE AVE
SPOKANE WA 99206
CONTACT: FALCO STOVE SHOP PHO. 509 92
SETBACKS -P FRONT: N/A N/A RIGHT _.� A
OWNER: DUONG, OUI
PHONE: 509 927 2265
ADDRESS: 13227 E GUTHRIE DR
SPOKANE WA 99216
MECHANICAL PERMIT
CONTRACTOR
FALCO GARDEN CENTER INC
LICENSE N: FALCOGC173DU
GAS LOG OR GAS INSERT 2
GAS.PIPING 2
PROCESSING FEE 25.00
TOTAL PERMIT FEE $47.00
czD% X37 IpC
LE
PAYMENT GATE RECE d a PAYMENT AMOUNT
09/18/97 00009073
TOTAL FEES AMOUNT PAID AMOUNT OWING
547.00
147.00
ISSUED PERMIT
$47.00 S.00
BY: WENDEL, GLORIA
go% -b be
RR-Lknclect